Provider Demographics
NPI:1447235999
Name:OUR ANGEL HOME HEALTH, INC.
Entity Type:Organization
Organization Name:OUR ANGEL HOME HEALTH, INC.
Other - Org Name:OUR ANGEL HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:ELENA
Authorized Official - Middle Name:
Authorized Official - Last Name:AUZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-629-9600
Mailing Address - Street 1:6080 SURETY DRIVE
Mailing Address - Street 2:SUITE 215
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79905-2065
Mailing Address - Country:US
Mailing Address - Phone:915-629-9600
Mailing Address - Fax:915-629-9602
Practice Address - Street 1:6080 SURETY DRIVE
Practice Address - Street 2:SUITE 215
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79905-2065
Practice Address - Country:US
Practice Address - Phone:915-629-9600
Practice Address - Fax:915-629-9602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-07
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008800251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1762973-01Medicaid
TX679470Medicare ID - Type UnspecifiedCMS